How Does a Hysterectomy Affect Menopause?

Dear HealthyWomen,

I’m 43 and have been suffering with abnormal and heavy bleeding and pain from uterine fibroids, which were discovered during a pelvic exam and subsequent ultrasound.

After trying various treatments with little improvement or success, I’m scheduled for a total hysterectomy. I’m OK about this, because I’m finished having children, and, frankly, I’ll be relieved to end the frequent bleeding and pain.

Many of my friends are starting to go through menopause and commiserating over hot flashes, insomnia, vaginal dryness and the like. That makes me very curious about something: I haven’t gone through menopause yet, so how will I know if I’m going through it if I’ve had a hysterectomy?

Signed,

Waiting for Menopause

Dear WFM,

First, let’s discuss what a total hysterectomy is. Your uterus and cervix will be removed. If you are having your fallopian tubes and ovaries removed as well (known as a salpingo-oophorectomy), that makes it much more likely that menopause will begin abruptly, since your body will no longer be producing as much estrogen. (For women who keep their ovaries, it’s probable that they’ll go through menopause at an earlier age than they might have if they never had the hysterectomy, but not abruptly.)

You will experience menopause differently than your friends who are going through a “natural” menopause. Your menopause is known as a surgical or induced menopause, and symptoms will likely begin immediately after the procedure. Because a surgical menopause is more sudden and abrupt than a gradual and natural menopause, it’s likely your symptoms (like hot flashes, vaginal dryness, mood swings and change in sex drive) will be more severe.

Some physicians treat surgical menopause with hormone therapy. Because your symptoms might be more drastic than someone going through a natural menopause, you might want to consider this option. There are also nonhormonal medications, like selective serotonin reuptake inhibitors, and complementary and alternative medicine and supplements that can be helpful.

But that’s not the only way to manage your symptoms. Lifestyle measures are worth exploring, too. For instance, to reduce hot flashes, cut down on your intake of alcohol, caffeine and spicy foods, and try to limit your stress and exposure to warm areas. These can all increase the risk for those pesky heat surges.

It’s not a bad idea to dress in layers for when the hot flashes strike, and carry a fan and ice water bottle with you whenever and wherever you can.

For more comfortable sex, you can use a water-based vaginal lubricant. And to keep your vagina comfortable at other times, a vaginal moisturizer can help as well.

Read: What Every Woman Should Know About Menopause.

It’s important to stay on top of your health by living a healthy lifestyle and regularly reassessing your health status and risk for disease. Induced menopause can increase your risk for some diseases (like osteoporosis and heart disease) because you no longer have the protective effects from estrogen and other ovarian hormones.

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When will you go through menopause after a hysterectomy and how will you know it? It depends on the type of hysterectomy.
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